Integrating Industry Standard Codes with Proprietary Reference Data: Health Insurance Case Study

In our environment, we have reference data that facilitates our claims processing, that has been in place for many years. There are industry standard code sets that have grown up around us, and these code sets grow and introduce new versions. In addition, there are standard data interchange formats such as HIPAA 837. Our enterprise has newly acknowledged the importance of code administration as a discipline. Reference data always brings with it the topic of governance. We have many stakeholders, and these codes are at the very heart of claims processing. This talk outlines our journey, how we are looking at integrating the proprietary and industry standard codes, supporting the systems of today at the same time transitioning to the systems of the future. The attendee will learn:
• Establishing Code Administration as a business discipline
• Transition strategies to industry standards
• Understanding stakeholders’ needs

Bonnie O'Neil is an internationally recognized expert on all phases of data architecture including data quality, business metadata, and governance. She is a regular speaker at many conferences and has also been a workshop leader at the Meta Data/DAMA Conference, and others; she was the keynote speaker at a conference on Data Quality in South Africa. She has been involved in strategic data management projects in both Fortune 500 companies and government agencies, and her expertise includes specialized skills such as data profiling and semantic data integration. She is the author of three books including Business Metadata (2007) and over 40 articles and technical white papers.